S266Heart, Lung and Circulation Abstracts 2009;18S:S1-S286 group using the Index of Relative Socioeconomic Disadvantage system, developed by the ABS from 2006 census data. Results: Patients in the lower SES groups were more likely to have higher BMI, diabetes, prior MI, lower ejection fraction, be current smokers, have chronic lung disease and obstructive sleep apnoea (all p < 0.0001). However, patients in the higher SES groups were more likely to be older, have private health insurance, have STEMI/NSTEMI as the indication for the index PCI, and receive IIb/IIIa-inhibitors and drug-eluting stents (all p ≤ 0.002). Despite dissimilarities in baseline characteristics, there were no differences in 12-month death or MACE amongst the SES groups. However, patients in the highest SES groups were more likely to have MI during 12-months follow-up, p = 0.03. Excluding MI patients from the MACE analysis did not influence outcomes. There were no differences in the use of aspirin, clopidogrel, beta-blockers or lipid-lowering therapy at 30-days or 12-months amongst the SES groups, though the lowest SES groups had less use of ACE-inhibitors and ARBs, p < 0.0001.Conclusion: These data suggest that patients with lower SES are not predetermined to have poorer outcomes if evidence-based therapies are prescribed following PCI.Background: There are inequalities in geographical access and delivery of health care services in Australia,
Cross calibration of DXA scanning equipment with phantom subjects has been recommended for assessing agreement between devices co-located within DXA scanning services.This study evaluated in-vivo and in-vitro cross calibration of a static and a mobile DXA scanner within the same service in their individual clinical settings. 50 individuals from a volunteer group were recruited to take part in this study and had DXA measurements made on two GE Lunar Prodigy Advance (GE Lunar, Bedford, UK) scanners.Results in this study showed that the scanners agreed, with no statistically significant differences in BMD measurements made at the same site on the individual devices used in this study. The in-vivo cross calibration of the instruments was a useful experience, which demonstrated closely calibrated systems and raised the profile of the bone densitometry service within the hospital.3 Introduction Central dual energy x-ray absorptiometry (DXA) of the spine and hip is the current preferred method for the diagnosis of osteoporosis [1]. DXA scanners have good long term precision due to stable calibration and effective instrument quality control procedures to detect long term drift [1]. However, the results from DXA scanners produced by different manufacturers and even the same make of scanner made by the same manufacturer cannot be directly compared due to potential differences in calibration [2]. When introducing additional or replacing DXA scanners it is therefore recommended to perform cross calibration whether the new machine is from the same manufacturer or not [3]. While cross calibration between two machines of the same manufacturer and using the same manufacture's phantom has been reported to have good agreement of 0.2%, in vivo measurements may differ by more than 2%[4] The increased errors in-vivo can be partly attributed to the increased precision errors introduced by virtue of scanning an individual who has in-homogeneity within their tissue, meaning that the x-ray photons may not pass though the same structures on both scans. Precision errors within DXA are also important for the characterisation of it's ability to assess bone mineral density and detect longitudinal change. Monitoring measurement errors within a service is also dependant on QA systems to detect scanner changes [5]. When introducing a new scanner, it is recommended to undertake a cross-calibration of the scanners within a service. The optimum technique for undertaking a cross-calibration study of DXA scanners is to use in-vivo measurements since this is how DXA scanners are used in clinical practice [4,6].In 2009, a GE Lunar Prodigy DXA scanner (GE Healthcare, Bedford, UK) was purchased and commissioned to operate in a mobile vehicle, alongside the existing static GE Lunar Prodigy within the Healthy Bones Service at Derriford Hospital (Plymouth UK). While it is not good practice to make longitudinal measurements of
patients was re-audited 6 months after the introduction of the late evening snack round to evaluate its impact. Carbohydrate content of food and drink were analysed using manufacturer's labels or a carbohydrate database [5]. The audit included 26 participant contacts pre and post-snack round. After introducing a late evening snack round the number of participants consuming !50g of carbohydrate increased, however, 50% still did not achieve this target. The mean total carbohydrate intake more than doubled and the number of participants consuming carbohydrate increased from 50 to 96%. The number of participants taking oral nutritional supplements increased, which contributed to total carbohydrate intake but did not significantly alter the number of participant consuming carbohydrate. This audit supports the practice of a late evening snack round on all hepatology wards as the total number of participants consuming carbohydrate and mean carbohydrate intake increased considerably. However, only 50% achieved !50g of carbohydrate, demonstrating that clinical guidelines can be challenging to implement in practice. Further work will focus on educating ward staff regarding what constitutes 50g of carbohydrate and how they can help patients to achieve this.
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